{"title":"Depth of Clinical Pharmacology in Undergraduate Medical Education","authors":"F. Goldstein","doi":"10.7556/jaoa.2019.104","DOIUrl":"https://doi.org/10.7556/jaoa.2019.104","url":null,"abstract":"","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"83 1","pages":"696 - 698"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83768730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract This review seeks to integrate the current literature to create a more unified and inclusive theory regarding the therapeutic mechanism of high-velocity, low-amplitude (HVLA) technique. The authors review the literature currently available regarding the physiologic effects of HVLA. The progression from an articulatory model to a neuromuscular one is discussed, and the body of work demonstrating that HVLA has a centralized mechanism of action, rather than just a local one, is described.
{"title":"Toward a Theory of the Mechanism of High-Velocity, Low-Amplitude Technique: A Literature Review","authors":"Kevin Hennenhoefer, D. Schmidt","doi":"10.7556/jaoa.2019.116","DOIUrl":"https://doi.org/10.7556/jaoa.2019.116","url":null,"abstract":"Abstract This review seeks to integrate the current literature to create a more unified and inclusive theory regarding the therapeutic mechanism of high-velocity, low-amplitude (HVLA) technique. The authors review the literature currently available regarding the physiologic effects of HVLA. The progression from an articulatory model to a neuromuscular one is discussed, and the body of work demonstrating that HVLA has a centralized mechanism of action, rather than just a local one, is described.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"3 1","pages":"688 - 695"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73738416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Victor Nuño, Al'-Deĭmer SIu, Stacey L. Pierce-Talsma
Context Limited research has been done to examine osteopathic manipulative treatment (OMT) effects on modulating a compilation of allostatic load (AL) biomarkers that work to measure the body's multisystem response to homeostatic deviation. Objective To examine the efficacy of OMT on graduate students' overall health through an objective index of representative AL biomarkers. Methods A within-subject pre- and postintervention study was conducted at Touro University College of Osteopathic Medicine in California during the fall 2017 semester. Graduate students enrolled in the Masters of Science in Medical Health Sciences program volunteered to participate in the study and received treatment by an osteopathic physician. The participants were evaluated using the following measures: Trier Inventory for the Assessment of Chronic Stress; diurnal urine cortisol and catecholamines; dried blood glycated hemoglobin, dehydroepiandrosterone, high-density lipoprotein, and high-sensitivity C-reactive protein; blood pressure, body mass index, and waist-to-hip ratio before (preintervention) and after (postintervention) OMT. Results The study consisted of 1 man (participant 1) and 1 woman (participant 2) aged 23 and 22 years, respectively. Participants were enrolled in the same academic program and received 3 OMT sessions in 7 weeks. Analysis of AL biomarkers revealed a decrease in overall AL scores from preintervention to postintervention in participant 1 (from 7 to 4) and participant 2 (from 9 to 7). Analysis of Trier Inventory for the Assessment of Chronic Stress scores revealed a decrease in self-perceived stress from preintervention to postintervention in participant 1 (from 18 to 15) and in participant 2 (from 40 to 13). Conclusion The OMT protocol used in the current study decreased measures of overall AL and self-perceived stress in both participants. This finding suggests that OMT may represent a reasonable modality to reduce AL and self-perceived stress in graduate students. Since the current study is limited by its small sample size, further research is warranted.
{"title":"Osteopathic Manipulative Treatment for Allostatic Load Lowering","authors":"Victor Nuño, Al'-Deĭmer SIu, Stacey L. Pierce-Talsma","doi":"10.7556/jaoa.2019.118","DOIUrl":"https://doi.org/10.7556/jaoa.2019.118","url":null,"abstract":"Context Limited research has been done to examine osteopathic manipulative treatment (OMT) effects on modulating a compilation of allostatic load (AL) biomarkers that work to measure the body's multisystem response to homeostatic deviation. Objective To examine the efficacy of OMT on graduate students' overall health through an objective index of representative AL biomarkers. Methods A within-subject pre- and postintervention study was conducted at Touro University College of Osteopathic Medicine in California during the fall 2017 semester. Graduate students enrolled in the Masters of Science in Medical Health Sciences program volunteered to participate in the study and received treatment by an osteopathic physician. The participants were evaluated using the following measures: Trier Inventory for the Assessment of Chronic Stress; diurnal urine cortisol and catecholamines; dried blood glycated hemoglobin, dehydroepiandrosterone, high-density lipoprotein, and high-sensitivity C-reactive protein; blood pressure, body mass index, and waist-to-hip ratio before (preintervention) and after (postintervention) OMT. Results The study consisted of 1 man (participant 1) and 1 woman (participant 2) aged 23 and 22 years, respectively. Participants were enrolled in the same academic program and received 3 OMT sessions in 7 weeks. Analysis of AL biomarkers revealed a decrease in overall AL scores from preintervention to postintervention in participant 1 (from 7 to 4) and participant 2 (from 9 to 7). Analysis of Trier Inventory for the Assessment of Chronic Stress scores revealed a decrease in self-perceived stress from preintervention to postintervention in participant 1 (from 18 to 15) and in participant 2 (from 40 to 13). Conclusion The OMT protocol used in the current study decreased measures of overall AL and self-perceived stress in both participants. This finding suggests that OMT may represent a reasonable modality to reduce AL and self-perceived stress in graduate students. Since the current study is limited by its small sample size, further research is warranted.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"1 1","pages":"e38 - e39"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88978016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response","authors":"A. C. Berry, E. McClain","doi":"10.7556/jaoa.2019.111","DOIUrl":"https://doi.org/10.7556/jaoa.2019.111","url":null,"abstract":"","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"21 1","pages":"644a - 645"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89048597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As chief residents of a previous dually accredited program and current Accreditation Council for Graduate Medical Education–accredited program with osteopathic recognition, we have seen how duty hour restrictions affect residents. We appreciate Berry and McClain’s update on the transition to the single accreditation system and synopsis of the iCOMPARE (Individualized Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education) trial and FIRST (Flexibility in Duty Hour Requirements for Surgical Trainees) trial. We second the idea of investigating individualized duty hour policies to promote resident well-being, specifically after reviewing iCOMPARE data. The iCOMPARE trial shows evidence of intern well-being negatively correlating with flexible duty hour restrictions in categories such as job satisfaction, career choice satisfaction, work-life balance, and overall well-being. Flexible duty hour restrictions also correlated to higher measures of burnout. This trend, on top of the study’s perceived “burned out” control group, suggests that individualized duty hours policies may benefit from options with reductions in duty hours. Interestingly, Piotrowski et al reported that among 748 medical students who had an understanding of extended residency length and decreased annual salary, more than half of the students preferred a 60-hour work week compared with an 80-hour work week. Additionally, students interested in primary care specialties and women were more likely to prefer reduced duty hour requirements. With iCOMPARE data showing pervasive burnout and current medical students’ interest in reduced duty hour options, we hope that individualized duty hour policies are comprehensively and objectively vetted in the future. The American Osteopathic Association’s Trainee Duty Hours Policy recognizes the need for strict duty hour mandates to aid in preventing poor resident wellbeing. In congruence with this policy, our residency has implemented policies to protect resident well-being. Two successful policies include weekly wellness breaks to promote fun collaboration between residents and faculty and protected time for each resident class. This protected time is in addition to traditional didactic sessions and ensures a personal collaborative network in each cohort. These strategies have been successful for the well-being of our residents, and we believe other residencies should consider adopting similar policies until individualized duty hours become a realistic option. (doi:10.7556/jaoa.2019.110)
{"title":"Resident Duty Hour Restrictions","authors":"Marshall T Ochi, Z. A. Stephan","doi":"10.7556/jaoa.2019.110","DOIUrl":"https://doi.org/10.7556/jaoa.2019.110","url":null,"abstract":"As chief residents of a previous dually accredited program and current Accreditation Council for Graduate Medical Education–accredited program with osteopathic recognition, we have seen how duty hour restrictions affect residents. We appreciate Berry and McClain’s update on the transition to the single accreditation system and synopsis of the iCOMPARE (Individualized Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education) trial and FIRST (Flexibility in Duty Hour Requirements for Surgical Trainees) trial. We second the idea of investigating individualized duty hour policies to promote resident well-being, specifically after reviewing iCOMPARE data. The iCOMPARE trial shows evidence of intern well-being negatively correlating with flexible duty hour restrictions in categories such as job satisfaction, career choice satisfaction, work-life balance, and overall well-being. Flexible duty hour restrictions also correlated to higher measures of burnout. This trend, on top of the study’s perceived “burned out” control group, suggests that individualized duty hours policies may benefit from options with reductions in duty hours. Interestingly, Piotrowski et al reported that among 748 medical students who had an understanding of extended residency length and decreased annual salary, more than half of the students preferred a 60-hour work week compared with an 80-hour work week. Additionally, students interested in primary care specialties and women were more likely to prefer reduced duty hour requirements. With iCOMPARE data showing pervasive burnout and current medical students’ interest in reduced duty hour options, we hope that individualized duty hour policies are comprehensively and objectively vetted in the future. The American Osteopathic Association’s Trainee Duty Hours Policy recognizes the need for strict duty hour mandates to aid in preventing poor resident wellbeing. In congruence with this policy, our residency has implemented policies to protect resident well-being. Two successful policies include weekly wellness breaks to promote fun collaboration between residents and faculty and protected time for each resident class. This protected time is in addition to traditional didactic sessions and ensures a personal collaborative network in each cohort. These strategies have been successful for the well-being of our residents, and we believe other residencies should consider adopting similar policies until individualized duty hours become a realistic option. (doi:10.7556/jaoa.2019.110)","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"7 1","pages":"644 - 644"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73523764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background The technique for the compression of the fourth ventricle (CV4) in the brain has been described as a method of reaching the physiologic centers that reside in its floor and of restoring optimal flow of the cerebrospinal fluid. However, a study published as an abstract in 1992 questioned whether CV4, when applied to pregnant women, could induce uterine contractions and possibly labor. Objective To further examine whether CV4 could induce uterine contractions and labor as part of the osteopathic manipulative treatment (OMT) protocol used in the Pregnancy Research in Osteopathic Manipulation Optimizing Treatment Effects (PROMOTE) study. Methods Labor and delivery data collected during the PROMOTE study from 2007-2011 were analyzed. The PROMOTE study was funded by the National Institutes of Health and was a randomized controlled clinical trial that measured the primary outcomes of back-specific functioning and pain in pregnant women aged 18 to 34 years. Participants were randomly divided into 3 groups—usual obstetric care only, placebo ultrasound treatment plus usual obstetric care, and OMT plus usual obstetric care. Study participants were scheduled for 7 treatment visits. Presented data were gathered from labor and delivery records. Results Four hundred participants were included. No significant differences were identified between treatment groups for the development of high-risk status (P=.293) or preterm delivery (P=.673). Evaluation of high-risk status by preterm delivery for the groups also showed no significant differences between groups (P=.455). Conclusion The application of CV4 as part of an OMT protocol during the third trimester caused neither a higher incidence of preterm labor nor the development of high-risk status.
摘要背景:压缩大脑第四脑室(CV4)的技术被描述为一种到达位于其底部的生理中心并恢复脑脊液最佳流动的方法。然而，1992年作为摘要发表的一项研究质疑，当CV4应用于孕妇时，是否会导致子宫收缩和可能的分娩。目的进一步探讨CV4作为骨科手法治疗(OMT)方案的一部分是否能诱导子宫收缩和分娩，并应用于骨科手法优化治疗效果(PROMOTE)的妊娠研究。方法对2007-2011年在PROMOTE研究中收集的分娩资料进行分析。PROMOTE研究由美国国立卫生研究院(National Institutes of Health)资助，是一项随机对照临床试验，测量了18至34岁孕妇背部特定功能和疼痛的主要结果。参与者随机分为3组:常规产科护理组、安慰剂超声治疗加常规产科护理组和OMT加常规产科护理组。研究参与者被安排进行7次治疗访问。所呈现的数据来自分娩和分娩记录。结果共纳入400人。在高危状态(P=.293)或早产(P=.673)方面，治疗组间无显著差异。两组间通过早产评估高危状态也无显著差异(P=.455)。结论在妊娠晚期应用CV4作为OMT方案的一部分既不会导致早产的发生率升高，也不会导致高危状态的发展。
{"title":"Does Compression of the Fourth Ventricle Cause Preterm Labor? Analysis of Data From the PROMOTE Study","authors":"Kendi Hensel, Brandy M. Roane","doi":"10.7556/jaoa.2019.114","DOIUrl":"https://doi.org/10.7556/jaoa.2019.114","url":null,"abstract":"Abstract Background The technique for the compression of the fourth ventricle (CV4) in the brain has been described as a method of reaching the physiologic centers that reside in its floor and of restoring optimal flow of the cerebrospinal fluid. However, a study published as an abstract in 1992 questioned whether CV4, when applied to pregnant women, could induce uterine contractions and possibly labor. Objective To further examine whether CV4 could induce uterine contractions and labor as part of the osteopathic manipulative treatment (OMT) protocol used in the Pregnancy Research in Osteopathic Manipulation Optimizing Treatment Effects (PROMOTE) study. Methods Labor and delivery data collected during the PROMOTE study from 2007-2011 were analyzed. The PROMOTE study was funded by the National Institutes of Health and was a randomized controlled clinical trial that measured the primary outcomes of back-specific functioning and pain in pregnant women aged 18 to 34 years. Participants were randomly divided into 3 groups—usual obstetric care only, placebo ultrasound treatment plus usual obstetric care, and OMT plus usual obstetric care. Study participants were scheduled for 7 treatment visits. Presented data were gathered from labor and delivery records. Results Four hundred participants were included. No significant differences were identified between treatment groups for the development of high-risk status (P=.293) or preterm delivery (P=.673). Evaluation of high-risk status by preterm delivery for the groups also showed no significant differences between groups (P=.455). Conclusion The application of CV4 as part of an OMT protocol during the third trimester caused neither a higher incidence of preterm labor nor the development of high-risk status.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"279 1","pages":"668 - 672"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77582868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lichen Nitidus","authors":"Alys S Jordan, Margaret C. Green, Daryl J. Sulit","doi":"10.7556/jaoa.2019.119","DOIUrl":"https://doi.org/10.7556/jaoa.2019.119","url":null,"abstract":"","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"164 1","pages":"704 - 704"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78557974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nancy Vitalone-Raccaro, M. Sheppard, Jacqueline M Kaari
Abstract Context In order to design undergraduate medical education responsive to the American Academy of Pediatrics’ recommendation that physicians learn about special education law and practices, it is important to understand medical students’ baseline knowledge about children with disabilities, special education law, available services, and the sources of this information. Objectives To develop an instrument to measure what second-year medical students know about children with disabilities, special education law, and available services; to determine the most common sources of this information; and to establish a baseline on which to design curricula that address this topic. Methods This study adopted a survey design. The survey took place in 1 school of osteopathic medicine in a Northeastern state of the United States. One hundred fifty medical students in their second year of full-time enrollment were invited to complete the survey. The instrument designed by the authors consisted of 30 items organized into a demographics section and 3 domains: (1) perceived level of knowledge about children with disabilities, (2) sources of information about children with disabilities, and (3) actual knowledge about children with disabilities and special education. Results Ninety-eight students (65%) participated. Although students were accurate in self-assessment, their source of knowledge was limited. Medical students who identified personal experiences (t=1.64) and coursework as their source of knowledge had more correct responses (t=2.62). Conclusion This preliminary study demonstrated a lack of knowledge among second-year medical students with regard to children with disabilities, special education laws, and social services. Curricula emphasizing disabilities and special education along with longitudinal experiential training may be effective methods to deliver these topics.
摘要背景为了设计符合美国儿科学会(American Academy of Pediatrics)建议医生学习特殊教育法和实践的本科医学教育，了解医学生对残疾儿童、特殊教育法、可用服务以及这些信息的来源的基本知识是很重要的。目的开发一种测量二年级医学生对残疾儿童、特殊教育法和可用服务的了解程度的工具;确定该信息的最常见来源;并建立一个基线，在此基础上设计解决这个问题的课程。方法采用问卷调查法。这项调查在美国东北部一个州的一所骨科医学院进行。150名全日制医学院第二年的学生被邀请完成这项调查。由作者设计的工具包括30个项目，分为人口统计部分和3个领域:(1)对残疾儿童的认知水平，(2)关于残疾儿童的信息来源，(3)关于残疾儿童和特殊教育的实际知识。结果98名学生参加，占65%。虽然学生的自我评价准确，但他们的知识来源有限。将个人经历(t=1.64)和课程作业作为其知识来源的医学生答对率更高(t=2.62)。结论本初步研究显示医二学生对残疾儿童、特殊教育法和社会服务的知识缺乏。强调残疾和特殊教育的课程以及纵向经验培训可能是传授这些主题的有效方法。
{"title":"Medical Students' Knowledge About Children With Disabilities, Special Education Laws, and Social Services: A Preliminary Scale Development and Pilot Study","authors":"Nancy Vitalone-Raccaro, M. Sheppard, Jacqueline M Kaari","doi":"10.7556/jaoa.2019.115","DOIUrl":"https://doi.org/10.7556/jaoa.2019.115","url":null,"abstract":"Abstract Context In order to design undergraduate medical education responsive to the American Academy of Pediatrics’ recommendation that physicians learn about special education law and practices, it is important to understand medical students’ baseline knowledge about children with disabilities, special education law, available services, and the sources of this information. Objectives To develop an instrument to measure what second-year medical students know about children with disabilities, special education law, and available services; to determine the most common sources of this information; and to establish a baseline on which to design curricula that address this topic. Methods This study adopted a survey design. The survey took place in 1 school of osteopathic medicine in a Northeastern state of the United States. One hundred fifty medical students in their second year of full-time enrollment were invited to complete the survey. The instrument designed by the authors consisted of 30 items organized into a demographics section and 3 domains: (1) perceived level of knowledge about children with disabilities, (2) sources of information about children with disabilities, and (3) actual knowledge about children with disabilities and special education. Results Ninety-eight students (65%) participated. Although students were accurate in self-assessment, their source of knowledge was limited. Medical students who identified personal experiences (t=1.64) and coursework as their source of knowledge had more correct responses (t=2.62). Conclusion This preliminary study demonstrated a lack of knowledge among second-year medical students with regard to children with disabilities, special education laws, and social services. Curricula emphasizing disabilities and special education along with longitudinal experiential training may be effective methods to deliver these topics.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"52 1","pages":"674 - 681"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74949292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Victor Nuño, Al'-Deĭmer SIu, Navneet Deol, R. Juster
Abstract Context Limited research has been done to examine osteopathic manipulative treatment (OMT) effects on modulating a compilation of allostatic load (AL) biomarkers that work to measure the body's multisystem response to homeostatic deviation. Objective To examine the efficacy of OMT on graduate students’ overall health through an objective index of representative AL biomarkers. Methods A within-subject pre- and postintervention study was conducted at Touro University College of Osteopathic Medicine in California during the fall 2017 semester. Graduate students enrolled in the Masters of Science in Medical Health Sciences program volunteered to participate in the study and received treatment by an osteopathic physician. The participants were evaluated using the following measures: Trier Inventory for the Assessment of Chronic Stress; diurnal urine cortisol and catecholamines; dried blood glycated hemoglobin, dehydroepiandrosterone, high-density lipoprotein, and high-sensitivity C-reactive protein; blood pressure, body mass index, and waist-to-hip ratio before (preintervention) and after (postintervention) OMT. Results The study consisted of 1 man (participant 1) and 1 woman (participant 2) aged 23 and 22 years, respectively. Participants were enrolled in the same academic program and received 3 OMT sessions in 7 weeks. Analysis of AL biomarkers revealed a decrease in overall AL scores from preintervention to postintervention in participant 1 (from 7 to 4) and participant 2 (from 9 to 7). Analysis of Trier Inventory for the Assessment of Chronic Stress scores revealed a decrease in self-perceived stress from preintervention to postintervention in participant 1 (from 18 to 15) and in participant 2 (from 40 to 13). Conclusion The OMT protocol used in the current study decreased measures of overall AL and self-perceived stress in both participants. This finding suggests that OMT may represent a reasonable modality to reduce AL and self-perceived stress in graduate students. Since the current study is limited by its small sample size, further research is warranted.
{"title":"Osteopathic Manipulative Treatment for Allostatic Load Lowering","authors":"Victor Nuño, Al'-Deĭmer SIu, Navneet Deol, R. Juster","doi":"10.7556/jaoa.2019.112","DOIUrl":"https://doi.org/10.7556/jaoa.2019.112","url":null,"abstract":"Abstract Context Limited research has been done to examine osteopathic manipulative treatment (OMT) effects on modulating a compilation of allostatic load (AL) biomarkers that work to measure the body's multisystem response to homeostatic deviation. Objective To examine the efficacy of OMT on graduate students’ overall health through an objective index of representative AL biomarkers. Methods A within-subject pre- and postintervention study was conducted at Touro University College of Osteopathic Medicine in California during the fall 2017 semester. Graduate students enrolled in the Masters of Science in Medical Health Sciences program volunteered to participate in the study and received treatment by an osteopathic physician. The participants were evaluated using the following measures: Trier Inventory for the Assessment of Chronic Stress; diurnal urine cortisol and catecholamines; dried blood glycated hemoglobin, dehydroepiandrosterone, high-density lipoprotein, and high-sensitivity C-reactive protein; blood pressure, body mass index, and waist-to-hip ratio before (preintervention) and after (postintervention) OMT. Results The study consisted of 1 man (participant 1) and 1 woman (participant 2) aged 23 and 22 years, respectively. Participants were enrolled in the same academic program and received 3 OMT sessions in 7 weeks. Analysis of AL biomarkers revealed a decrease in overall AL scores from preintervention to postintervention in participant 1 (from 7 to 4) and participant 2 (from 9 to 7). Analysis of Trier Inventory for the Assessment of Chronic Stress scores revealed a decrease in self-perceived stress from preintervention to postintervention in participant 1 (from 18 to 15) and in participant 2 (from 40 to 13). Conclusion The OMT protocol used in the current study decreased measures of overall AL and self-perceived stress in both participants. This finding suggests that OMT may represent a reasonable modality to reduce AL and self-perceived stress in graduate students. Since the current study is limited by its small sample size, further research is warranted.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"44 1","pages":"646 - 654"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74302349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Neuropathologic confirmation of dementia with Lewy bodies (DLB) involves labeling cytoplasmic Lewy body inclusions for α-synuclein in cortical and subcortical neurons. The authors studied the postmortem brain of a 78-year-old man who had a diagnosis of DLB by exclusion. The patient had symptoms ascribed to DLB that included fluctuating cognitive changes in attention and executive function with progression to dementia, visual hallucinations, and parkinsonism. Sections from the olfactory bulbs and cortical and subcortical regions were stained with periodic acid-Schiff, as well as immunolabeled with antibodies specific for α-synuclein, tau protein, β-amyloid 1-42, and Chlamydia pneumoniae. Most regions demonstrated mixed neuropathologic features, and α-synuclein was notable in Lewy bodies in the amygdala and hippocampus. Periodic acid-Schiff–positive staining was noted in bodies in the amygdala and olfactory bulbs. In this case of DLB, neuropathologic inclusions were consistent with the disease diagnosis, but also with Alzheimer disease and other neurodegenerative diseases, such as polyglucosan body disease.
{"title":"Intriguing Mixed Pathologic Features in a Case of Dementia With Lewy Bodies","authors":"B. Balin, C. Hammond, K. Galluzzi","doi":"10.7556/jaoa.2019.106","DOIUrl":"https://doi.org/10.7556/jaoa.2019.106","url":null,"abstract":"Abstract Neuropathologic confirmation of dementia with Lewy bodies (DLB) involves labeling cytoplasmic Lewy body inclusions for α-synuclein in cortical and subcortical neurons. The authors studied the postmortem brain of a 78-year-old man who had a diagnosis of DLB by exclusion. The patient had symptoms ascribed to DLB that included fluctuating cognitive changes in attention and executive function with progression to dementia, visual hallucinations, and parkinsonism. Sections from the olfactory bulbs and cortical and subcortical regions were stained with periodic acid-Schiff, as well as immunolabeled with antibodies specific for α-synuclein, tau protein, β-amyloid 1-42, and Chlamydia pneumoniae. Most regions demonstrated mixed neuropathologic features, and α-synuclein was notable in Lewy bodies in the amygdala and hippocampus. Periodic acid-Schiff–positive staining was noted in bodies in the amygdala and olfactory bulbs. In this case of DLB, neuropathologic inclusions were consistent with the disease diagnosis, but also with Alzheimer disease and other neurodegenerative diseases, such as polyglucosan body disease.","PeriodicalId":16639,"journal":{"name":"Journal of Osteopathic Medicine Journal of Osteopathic Medicine","volume":"26 1","pages":"632 - 636"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78046486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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